Obara K, Itoh Y, Tanaka K, Tanahashi N, Koto A
Department of Neurology, Keio University School of Medicine.
Rinsho Shinkeigaku. 1996 Jul;36(7):869-75.
We report two patients with primary low spinal fluid pressure syndrome with pachymeningeal gadolinium enhancement. Case 1 was a 36-year-old man and case 2 was a 29-year-old man. Each case developed postural headache and had no histories of head trauma, craniotomy or lumbar puncture. The spinal fluid pressures were 20 mmH2O in case 1 and 0 mmH2O in case 2 at decubitus position. Cranial MRIs revealed diffuse pachymeningeal enhancement after gadolinium infusion, flattening of the pons, and tight posterior fossa in each case. Their headache spontaneously resolved within a couple of weeks by bed rest and intravenous hydration. Follow-up MRIs which were examined 3 or 4 months later, revealed a remarkable reduction in the degree of pachymeningeal enhancement, flattening of the pons and tight posterior fossa. Primary low spinal fluid pressure syndrome should be included in the differential diagnosis of pachymeningeal enhancement on MRI.
我们报告了两例原发性低脑脊液压力综合征伴硬脑膜钆增强的患者。病例1为一名36岁男性，病例2为一名29岁男性。两例患者均出现体位性头痛，且无头部外伤、开颅手术或腰椎穿刺史。卧位时，病例1的脑脊液压力为20 mmH₂O，病例2为0 mmH₂O。头颅磁共振成像显示，钆注入后两例患者均出现弥漫性硬脑膜增强、脑桥扁平及后颅窝狭窄。通过卧床休息和静脉补液，他们的头痛在几周内自行缓解。3或4个月后复查的磁共振成像显示，硬脑膜增强程度、脑桥扁平及后颅窝狭窄均有显著减轻。原发性低脑脊液压力综合征应纳入磁共振成像上硬脑膜增强的鉴别诊断。
